Prevent Medical Billing Errors to Maintain Healthy Patient-Provider Relationship

Medical Billing Errors
Picture courtesy: keesler.af.mil

A healthcare facility’s growth depends on the healthy patient-provider relationship that is dependent on the quality of services the facility provided to the patients. Healthcare facilities work hard in every department right from the physicians to the support staff to ensure that the patients have a positive experience with the facility and get great patient care. However, all these efforts become futile when the patients receive a medical bill with errors from the revenue cycle management staff. Avoiding these common billing errors can save healthcare facilities from developing negative patient-provider relationship:

  • Wrong entry of patient details: One of the most annoying causes of medical claim denials is inaccurate or incomplete patient information in the medical bills. Things that may look trivial like a misspelt patient name or incorrect policy number can play a pivotal role in the claim denial. Persons involved in RCM services should always ensure to input accurate and complete patient information to avoid claim denials, get timely reimbursements, and maintain healthy patient relations.
  • Avoid mismatch of codes: Many times, patients suffer a lot of inconveniences and sometimes agony too because of wrong medical bills given by the revenue cycle management staff. Billing errors can happen when wrong codes are entered in the bills for the services provided either due to technological or human error. Entering correct code is essential to arrive at the correct bills otherwise it may result in patients getting angry for the incorrect bills.
  • Duplication of codes: As per rules, a medical claim should not have any duplicate ICD-10 CM diagnosis code within item 21 or else; the claim will be unprocessed and returned. To avoid this, RCM services providers should ensure avoiding any duplication of codes.
  • Upcoding: Whether accidental or intentional, the addition of unnecessary services or procedures in the bills will spoil the provider-patient relationship. Upcoding in a bill happens when a patient gets a bill more expensive than what it actually should have been for the service provided. A upcoded bill may be sent to an insurance provider or the patient. Whatever the case may be, when the bill is wrong it will affect the healthcare facility because the insurance provider will decline the claim or the patient will refuse to pay more for the wrong bill.

To avoid errors resulting in a poor provider-patient relationship and a negative impact on the financial position of the facility, every healthcare facility should have a robust revenue cycle management process in place. Else, it should ensure flaw-less bills by outsourcing the process to the best RCM services providers.

Prevent Medical Billing Errors to Maintain Healthy Patient-Provider Relationship
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